The Study of Care Need Assessment with Comprehesive Assessment Tool for Long Term Care in China: Taking the Use of CARE in ShangHai as an Example (Preprint)

BACKGROUND Comprehensively evaluating the care needs of older adults is the premise for implementing integrated care. Nonetheless, the system as a pilot project is still at the observation stage in several cities. Shanghai was the first city to launch a medical and long-term care integrated comprehensive assessment, and at this stage, validating whether the current care needs assessment scale effectively identifies older people’s care needs is vital. OBJECTIVE The objectives of this study is to design and establish a mobile care platform(mCARE+) integrating assessment implementation, care issue identification, and care planning comprehensive assessment instrument, then use the technology acceptance model for mobile services (TAMM) questionnaire to investigate care-providing staff’s technology acceptance of mCARE+. METHODS First, the expert assessment approach was adopted to combine the CARE and UCNAS to form a new comprehensive assessment instrument, CARE+. Second, the Resident Assessment Instrument (RAI) 3.0 was decomposed to determine the logic for generation of care issues, which could be used to form care issues triggered by CARE+. Third, the 3 + 1 hierarchical matrix interface design principle was employed to establish CARE+ and care procedures on the mobile care platform, forming mCARE+, an application platform linking assessment to care issue identification. Fourth, convenience sampling was adopted to select 18 nursing employees from a hospital and its affiliated nursing home in Shanghai for technology acceptance evaluation of mCARE+ utility, ease of use, reliability, acceptance, and satisfaction. RESULTS and the total level of satisfaction reached 100%. Their levels of satisfaction for its ease of use and usefulness were both greater than 90%; however, approximately one-third of the participants were concerned about data security. CONCLUSIONS The present study demonstrated that the intended applications of a comprehensive assessment can be achieved by using technology effectively. Several critical care issues were overlooked when using the unified care needs assessment scale, which is currently used in Shanghai. Whether the results of the assessment can be directly applied to ascertain a suitable care facility for an older person and plan the corresponding care measures requires further investigation. These overlooked critical care issues may affect health care outcomes and care resource usage; therefore, these issues should be considered when deciding on the care level and expenditure.

Coronary Artery Disease

Coronary artery bypass grafting (CABG), first introduced in 1968, is now one of the most common surgical procedures and the most common cardiac procedures worldwide. It is estimated that over 800,000 CABG surgeries are performed worldwide each year. The goals of CABG are to reduce mortality, prevent the progress of heart failure and reduce symptoms associated with coronary artery disease. This chapter deals with cardiac critical care issues that pertain to the patient undergoing CABG and potential post-operative complications.

Coronary Artery Disease

Coronary artery bypass grafting (CABG), first introduced in 1968, is now one of the most common surgical procedures and the most common cardiac procedures worldwide. It is estimated that over 800,000 CABG surgeries are performed worldwide each year. The goals of CABG are to reduce mortality, prevent the progress of heart failure and reduce symptoms associated with coronary artery disease. This chapter deals with cardiac critical care issues that pertain to the patient undergoing CABG and potential post-operative complications.